Scalp - burning, itching, pain

Structure and function of the scalp

The scalp is the part of our skin that surrounds our head and protects it from external damage such as UV radiation, pathogens and chemicals.
The skin also serves, as in other parts of the body, for heat exchange and fluid regulation and thus protects against overheating and cooling. It is made up of several layers. The top layer is called the epidermis or cuticle. Below is the dermis - the leather skin that attaches to the subcutaneous tissue - the subcutaneous tissue. In addition to the hair roots, sweat and sebum glands as well as nerves are embedded in the layers.

Itchy scalp

An itchy scalp can have numerous causes. A rough distinction must be made between itching of the scalp caused by external skin irritations that also lead to the scalp drying out, skin diseases such as neurodermatitis, parasite or fungal infections, allergic reactions and psychosomatic complaints. It is important to find out the cause in order to be able to take targeted action against it.

The central messenger substance that ultimately causes us to feel itchy is histamine. It is released in the brain, causing us to feel the need to scratch. The scratching leads to damage to the skin. Depending on how strong the itching is felt and then scratched, deeper layers of the skin can also be damaged. The result can be an intensification of the itching. In addition, the damaged skin is more susceptible to colonization with bacteria and viruses, which can also worsen the symptoms and lead to a serious feeling of illness.

Normally, the sebum glands of the skin produce an oily substance that wraps itself around the scalp like a protective shield and protects it from drying out and chemically toxic substances. If this barrier is broken, the skin is more vulnerable, which in the end results in skin irritation and itching. Too frequent washing of the hair with shampoo or the use of numerous other hair care products, such as hairspray or hair dye, can contribute to the dissolution of this barrier and in the course also lead to the fact that the body becomes sensitized to the substances contained therein and reacts allergically with further use.

Read more on this topic at: Dry scalp

Other causes of itchy scalp

Neurodermatitis

In atopic dermatitis, the structure of the skin is disturbed from birth, which results in a defect in the skin barrier from the start.
Children are particularly affected. Foreign substances can penetrate the skin and lead to an inflammatory reaction with the formation of antibodies. This makes the skin very sensitive and flakes off quickly. The children experience severe itching. Scratching also damages the skin barrier and makes it more susceptible to possible allergens, which further intensifies the symptoms.

Read more on the topic: Neurodermatitis

psoriasis

Another genetic cause of scalp itching is psoriasis.
Typical for this disease are circular, reddish skin irritations that are very flaky. The strong scaling is based on a defect in the skin renewal process that happens far too quickly for those affected.

Further information on the topic: psoriasis

Seborrheic eczema

Having seborrheic dermatitis (Unna's disease) in turn is a rash that occurs almost exclusively on the face and scalp. As a rule, babies younger than 3 months are affected. With them, eczema is often mistakenly mistaken for cradle cap. A second peak of illness occurs between the ages of 20 and 40.

Those affected suffer from a yellowish, scaly rash, which is mainly found on the scalp and in the skin areas around the nose, chin, eyebrows and ears. The affected areas are often accompanied by severe itching. The cause has not yet been fully clarified. It was found that the majority of people are genetically predisposed, but only a fraction of them are affected. It is believed that the condition of the immune and central nervous systems play an important role as the disease is common in AIDS and Parkinson's patients, especially in adulthood.

Read more on the topic: Seborrheic eczema

Multiplication of the yeast Malassezia furfur

A connection with the excessive reproduction of the otherwise harmless yeast fungus Malassezia furfur, which has no disease value in healthy people, is also being discussed.

Oily skin creams are not suitable for treatment, as they visibly worsen the symptoms. External immunomodulators, such as tacrolimus and pimecrolimus, and short-term use of cortisone-containing creams are more suitable. However, a doctor should be consulted for diagnostics and extensive advice.

Also read our topic: Yeast fungi on the scalp

head lice

Probably the best known parasites that can attack the scalp are head lice. These are mainly found in children who are in small groups, as is the case in kindergartens and schools. Statistically, it is the most common childhood parasitic infection. They are transmitted through close head contact between a sick person and a healthy person. Infection through contaminated combs, hats or pillows are very rare, as the lice would only survive outside the head for a very short time. The infestation does not depend on the child's personal hygiene or how often they wash their hair.

The lice feed on human blood, which they obtain by scratching the scalp. The louse's injected saliva prevents the blood from clotting so that it can absorb more blood during a blood meal. The infected person's body reacts to the foreign lice saliva with an inflammatory reaction and reacts to it with severe itching. The parasites prefer to stay in areas with thick hair, such as on the temples, in the neck and behind the ears, as these are the ideal conditions for oviposition. If the infestation is prolonged, these areas are particularly noticeable with bloody scratch marks.

The parasitic scalp infestation is diagnosed mostly by chance, if a louse is noticed while combing or on closer inspection of a child who often scratches himself. Searching the hairline for eggs can also help. This is best done with the help of a so-called nit comb, with which the eggs or empty egg shells of already hatched lice can be fought out of wet hair. If the comb is wet, lice can get caught in the comb and be seen when brushing the comb onto a white cloth.
The treatment consists on the one hand of applying a local substance, usually in the form of a shampoo, which kills the lice. This may have to be repeated several times. On the other hand, the hair should be combed out with the nit comb after washing to remove eggs and lice.

Also read: Burning in the neck

Mites

Another parasite that can make the scalp itch is the mite.
Often a rash with reddish bumps on the skin occurs, this is mostly not limited to the scalp. The itching typically occurs more frequently during the night.
The mites are also transmitted through close physical contact.

Read more on the subject at: Rash from mites

Psychosomatic complaints

Psychogenic complaints such as stress can make the scalp itch, although no other tangible cause can be found. It is believed that itching is caused by sensory disturbances in the skin. The psychological and / or physical stress leads to a reflex tension in the scalp. Those affected perceive this from a slight tingling sensation to a strong burning sensation. This is often accompanied by headaches and hair loss.

The best therapy is to learn relaxation exercises so that the muscle tension is released. Muscle-relaxing substances can provide a short-term remedy, but in the long term contribute to a relaxed posture by reducing the symptoms. Treatment of the itchy scalp depends on what triggered the symptoms. For any itchy scalp, it is better not to give in to it.

If the skin is injured by scratching, the symptoms can become immensely worse. In addition, the healing process of the already damaged and irritated skin is dragged out. Salt water provides relief from itching. Subsequently, positive effects were achieved with the application of St. John's wort oil or evening primrose seed oil. Perfumed shampoos should be avoided as they can cause and worsen skin irritation.

Pain or burning sensation on the scalp

There are several causes of a sore scalp:

• Sunburn: If you have been exposed to the sun during the day, your scalp may well be sunburned. In this case, it helps to cool the skin and avoid further exposure to the sun.
• Tightly tied braid: Sometimes the scalp only hurts from wearing a braid that is tied too tightly. By loosening the braid, this pain subsides on its own.
• Use of new care products: If a new care product has been used, it is quite possible that the scalp reacts allergically to contact with the new substance. In this case, the product should no longer be used!
• Inflammation: It is also possible that the scalp is properly inflamed. Signs of inflammation include redness, pain, swelling, and warmth, and, in the case of a bacterial infection, pus. In this case, you should urgently consult a dermatologist. By taking a sample from the affected area of ​​skin, it can be determined whether the infection was caused by bacteria or fungi.

The technical term for scalp pain is trichodynia. Trichos stands for "hair", dynê is the Greek name for pain. Those affected suffer from abnormal scalp sensations, which, unlike headaches, emanate directly from the irritated skin and hair roots. They report that the scalp is sensitive to touch, which causes pain and problems, especially when combing hair. There are many different forms. Some report tingling or pins and needles, others itching, a feeling of tension or severe, burning pain.

In addition to the symptoms mentioned, a large number of them suffer from hair loss and tension headaches.The disease is usually based on psychological complaints. For most of those affected, no pathological changes that could explain the symptoms can be found in the course of an examination. Extreme stress leads to muscle tension, so that the thin muscle strands below the scalp also tighten. Due to the increased muscle tone, the smallest vessels that supply the scalp and hair roots with blood are squeezed out. The result is an insufficient supply of oxygen and nutrients, as well as an accumulation of harmful metabolic products, including lactate. The small muscle cords become acidic and partially tear.

Read more on the topic: Sore scalp

In combination with the tension, this leads to the release of numerous messenger substances that suggest a painful process to the brain. This culminates in additional psychological stress and increasing pain and hair loss. However, this vicious circle can be broken with relaxation exercises, massages and medication to relax the muscles. The medication inhibits the permanent transmission of signals from the nerves to the muscle, causing it to relax.

This provides those affected with acute relief after two to three days. Treating tension and the associated discomfort is the first step towards relaxation. However, it makes sense to learn relaxation exercises over the long term. This can be done as part of autogenic training or yoga. If manifest psychological problems are the cause of the painful scalp, a neurologist should also be consulted, as the persistent pain can increasingly worsen the underlying problem.

More information on this topic: Burning scalp

Dandruff on the scalp

The entire skin is constantly regenerating and renewing itself. So does the scalp. Dead, cornified cells are shed in groups from the top layer of skin as scales. In technical terms, this natural process is called desquamation. If this process is normal, the flaked skin cells cannot be seen with the naked eye. However, this process can be disturbed and flaking increased. If more than 500 contiguous, dead cells fall off the scalp, they become visible as large white platelets, especially on dark clothing.

As a rule, dander does not have any disease value, but is often perceived as unaesthetic and therefore annoying. Two different types can be roughly distinguished from one another. Dry dandruff is white in color and usually occurs on a dry scalp. Causes are dry heating air in winter, blow-drying that is too hot, sunburn or the use of drying shampoos. Some skin diseases, especially psoriasis (psoriasis) are expressed by increased dry flaking.

You might also be interested in this topic: Dry scalp- what should you do?

Fatty dandruff is caused by excessive sebum production and therefore appears yellowish. They exceed dry scales in size and feel oily. Since they peel off much more slowly, like dry scales, they form an ideal breeding ground, especially for the otherwise non-pathogenic skin fungus Malassezia furfur. The cause can be hormone fluctuations, especially during puberty, which lead to increased sebum production. As with so many others, in addition to the causes mentioned, hereditary predisposition, i.e. whether close relatives also tend to increase dandruff, plays a major role in the development.

Find out more about the topic: Proper care for oily skin

As already said, dandruff is usually not a disease-related problem. However, one should be prudish if the dandruff does not go away despite treatment, as an illness and not just a dry scalp can then be behind it. It is advisable to consult a specialist, preferably a dermatologist, if the peeling is accompanied by hair loss, burning pain, weeping, inflamed areas of the scalp or reddened, swelling-prone skin.

Anti-dandruff shampoos can help and counteract the annoying dandruff. Many anti-dandruff shampoos also contain an active ingredient against fungi and are therefore also suitable for use on oily dandruff. However, it is important to note that you do not choose a shampoo that will further dry out the scalp. The opposite effect would result in increased flaking. Furthermore, the shampoo should not be used for longer than a month, as it leads to skin irritation in the long term.

Washing your hair too often, more than once a day, should also be avoided. The scalp should be protected from excessive sun exposure by wearing a hat. If these measures do not help, the doctor can prescribe a shampoo containing salicylic acid, which promotes the detachment of the dandruff and subsequently makes the scalp more receptive to care substances. This shampoo is also only intended for short-term use over a few days. Vitamin D3 analogs are anti-inflammatory and can be taken for up to a year. They also slow down dandruff.

Read more on the topic: Dandruff- the right treatment

Scalp stinks

A stench that emanates from the scalp just a few hours after washing their hair can be very stressful for those affected. The cause is usually an excessive increase in otherwise benign skin fungi. This can be safely diagnosed with the help of a smear done by the doctor. On the one hand, growth is promoted by increased sebum production by the scalp.

Paradoxically, washing your hair too often, especially with aggressive, drying shampoos, promotes this. Many people are also predisposed to excessive sebum production. On the other hand, excessive sweating and the resulting constantly moist scalp also contribute to the multiplication of fungi and bacteria. The components contained in sweat and sebum are decomposed by the fungi and, above all, by bacteria on the skin and perceived as an unpleasant, musty odor.
If a fungus has been detected, a shampoo containing an anti-fungal drug can help. Allowing your hair to air dry from time to time instead of blow-drying helps the scalp to regenerate and counteract dryness and the associated excessive sebum production.

Scalp tight

If the scalp is "tight" this is a sign of a dry scalp. Many people also know this feeling from the skin of their face and therefore use creams, which reduce the feeling of tension. Our skin can actually protect itself, because it is capable of "greasing" itself. However, it is precisely this fat that we don't like in our hair. Frequent washing to remove the annoying fat deprives the skin of its natural protection.

Without its natural barrier, the skin loses a lot of moisture, it becomes dry, itches and gives us a feeling of tension. In addition, we stress our scalp every day with hot blow-drying and dry air from heating in the cold season. In this case, dermatologists recommend using shampoos that contain natural urea (also called urea). Urea is a substance that is also produced by the body itself and is able to bind fluids. As a result, the scalp loses less moisture, it dries out less and the feeling that the scalp is tight decreases.

Irritated scalp

Our scalp is exposed to a lot of stress these days. These include, for example, the dry air from heating in winter and frequent washing, which deprives the scalp of its natural protection (the fat!). Often the scalp then tends to dry out and this leads to unpleasant itching. Dermatologists recommend using shampoos that contain urea. Urea is nothing more than urea, it can bind moisture and thus counteracts the drying out of the scalp.

If the symptoms such as itching, pain or flaking of the scalp do not improve, you should contact a dermatologist, especially if severe redness or open skin areas are visible. In this case, the dermatologist can find out whether it is a fungal or bacterial infection and prescribe an appropriate medical product with an antifungal agent against fungi or an antibiotic against bacteria.

Read more on the topic: What should I do if my scalp is dry?

The head fungus

The term head fungus is understood to mean an infestation and infection of the scalp by skin fungi, also known as dermatophytes in technical terms. Children in particular are affected by this disease. The two most common forms of fungus that cause infection are usually transmitted by infected pets such as dogs, cats, hamsters and guinea pigs, but sick people are also a source of infection for others.

In the area of ​​the affected scalp areas, the hair breaks off near the skin. These sharply delimited areas resemble a mown cornfield. The scalp underneath can also appear more flaky in comparison, but also have a completely healthy appearance.

However, the scalp is irritated, even if it appears normal, and the fungal attack makes it more susceptible to additional infection (Superinfection) by bacteria that are also found on the skin of healthy people. If this is the case, the wound surface appears oozing and purulent. In the worst case, the inflammation spreads to the hair roots, causing the hair to fall out. If the roots are completely destroyed, the infected areas will remain bare for life.

Find out more about the topic: Hair loss

Diagnosis of head fungus

The doctor takes a small sample of the scalp for diagnosis. On the one hand, this can be examined for fungal infestation under the microscope, and on the other hand, the fungus can also be grown in a culture with subsequent identification. If the areas affected by fungi are not superinfected with bacteria, local treatment using fungicidal ointments or shampoos is usually sufficient.

The areas that are not obviously affected, i.e. the entire scalp, should also be treated, since fungi have usually also accumulated there. It can take up to 8 weeks for the scalp to be free of dermatophytes. The treatment time can be shortened by cutting off the hair. It is important not to interrupt the therapy, even if the first visible results have already occurred. If the therapy is ended too early, there is a risk that individual fungi will have survived the previous therapy and are now able to cause a renewed infection of the scalp.

In severe cases, taking antifungal drugs (antimyotics) in the form of tablets can be useful, although not all of them are well tolerated by children and are therefore not suitable for them. It therefore makes sense to see a doctor and get advice on the right therapy.

In order to avoid renewed infestation, all cuddly toys, covers, pillows, etc. should also be cleaned, as the fungi survive in them for a short time and thus represent a source of infection. Strengthening the immune system is not only the best prevention for head fungus infections, but also for pathogens of all kinds and is therefore particularly recommended.

Read more on the topic: Fungal infection drugs

Pimples on the scalp

In the majority of cases, pimples on the scalp appear similar to the pimples that can be found on the face, décolleté or back. Usually, clogged pores are the beginning of the evil. The sebum glands usually end at the hairline. If a blockage occurs, bacteria can multiply in the duct and on the hair roots. The result is a purulent pimple. They are mainly found on the hairlines along the forehead and neck. However, many pimples that appear suddenly and are spread over the entire scalp can be an indication of allergies and should therefore be clarified by a doctor. Allergen-related pimples are usually accompanied by severe itching and oozing of the skin. Triggers can be newly used hair care products.

If there is a suspicion of a possible allergic reaction, these should not be used under any circumstances until an allergy test by the doctor has provided no certainty. When in doubt, it is always better to use another care product. Quite a few people are also allergic to newly used detergents. There is a reaction when wearing a hat or while sleeping on freshly washed bed linen.

Natural remedies such as chamomile tea can also be used to relieve itching and accelerate healing. Good results can be achieved by massaging the scalp after washing the hair when it is lukewarm. The tea should not be rinsed out of the hair. Fragrance-free, pH-neutral shampoos should be used. Chemical coloring of hair should be avoided if there are numerous pimples on the scalp, as this can be made immensely worse. Eating a healthy diet will also help reduce the number of breakouts, at least those that are caused by clogged pores.

Read more on this topic at: Red spots on the scalp such as Boils on the head

Care tips for a healthy scalp

Our scalp is stressed every day by frequent washing, various styling products and, especially in the cold season, by strong temperature fluctuations. Since many people do not want to do without their daily hair wash, you should at least pay attention to which product you use for it. Shampoos without fragrances or preservatives are best suited.

You should also avoid hot blow-drying and protect your scalp from the sun in summer. There are different ways to do something good for your scalp.

A peeling for the scalp is now offered by various dermatologist's practices and is said to have the same effect as on the face or décolleté. Remnants of styling products that cannot be removed with daily hair washing are removed. In addition, chemical peeling with fruit, glycolic or salicylic acid is also used for acne and light-induced skin cancer precursors such as actinic keratosis.

Different creams and lotions, on the other hand, can contain special active ingredients and, depending on this, can be used for different diseases such as different forms of hair loss. Some people like to use natural olive oil as a home remedy for dry scalps, but leave the oil on overnight for use. Various tonics that are offered for scalp care mostly contain urea. Urea is nothing more than urea, it can bind moisture and thus counteracts the itching and the feeling of tension that arise from a dry scalp.

More on this: Skin care